瘢痕部位血管微循环参数联合3D-CPA、MRI在子宫瘢痕妊娠的早期评估中的应用  

Application of vascular microcirculation parameters at the scar site combined with 3D-CPA、MRI in early evaluation of uterine cesarean scar pregnancy

作　　者：康燕 李秀琴[1] 侯亚 李娜[1] KANG Yan;LI Xiuqin;HOU Ya;LI Na(Hengshui Second People’s Hospital DeliveryRoom,Hebei Hengshui 053000,China)

机构地区：[1]衡水市第二人民医院产房,河北衡水053000

出　　处：《中国实验诊断学》2025年第1期46-50,共5页Chinese Journal of Laboratory Diagnosis

基　　金：衡水市科技计划项目(2020014011Z)。

摘　　要：目的观察子宫疤痕处妊娠(CSP)患者瘢痕处血管微循环参数与三维彩色能量多普勒(3D-CPA)、磁共振成像(MRI)参数值,分析瘢痕部位血管微循环参数与3D-CPA、MRI联合用于CSP患者的早期检出中的价值,以期为临床剖宫产术后瘢痕妊娠的早期检出提供影像学参考。方法选取衡水市第二人民医院2023年1月至2023年12月期间收治的50例CSP孕妇,纳入观察组,采集同时期内在衡水市第二人民医院建档产检的50例剖宫产再妊娠且排除瘢痕妊娠的孕妇资料并将其纳入对照组,纳入对象均开展三维彩色能量多普勒与MRI检查,对比两组孕妇三维彩色能量多普勒与MRI检查的参数值,分析瘢痕部位血管参数联合MRI在瘢痕妊娠的早期评估中的价值。结果与对照组相比,观察组孕妇瘢痕部位血管参数中VI、FI、VFI值均较高,差异有统计学意义(P<0.05);与对照组相比,观察组孕妇MRI参数中瘢痕厚度值较高,剩余肌层厚度值较低,差异有统计学意义(P<0.05),两组孕妇孕囊邻近正常肌层厚度值对比,差异无统计学意义(P>0.05);绘制ROC曲线结果显示,血管瘢痕处参数(VI、FI、VFI值)及MRI参数(瘢痕厚度、剩余肌层厚度)值预测子宫瘢痕妊娠的AUC均>0.70,预测价值均较理想,尤以联合预测AUC最大,预测价值最高。结论针对剖宫产术后再妊娠孕妇,妊娠早期通过及时开展三维彩色能量多普勒联合MRI检查,观察瘢痕处血管微循环参数值、瘢痕厚度及剩余肌层厚度,可有效提高瘢痕妊娠的早期检出率,对指导临床进一步干预提供影像学参考。Objective To observe the vascular microcirculation parameters at the scar site combined with 3D-CPA magnetic resonance imaging(MRI)in patients with uterine cesarean scar pregnancy(CSP),and analyze the value of the combination of vascular microcirculation parameters at the scar site combined with 3D-CPA MRI in early detection of CSP patients,so as to provide imaging reference for early detection of scar pregnancy after cesarean section.Methods Fifty pregnant women with CSP admitted to our hospital from January 2023to December 2023were enrolled in the observation group,and the data of 50pregnant women with cesarean section and scar pregnancy excluded in our hospital during the same period were collected and included in the control group.All the subjects were examined by three-dimensional color power Doppler and MRI.The parameter values of three-dimensional color power Doppler and MRI were compared between the two groups,and the value of vascular microcirculation parameters of scar site combined with MRI in early evaluation of scar pregnancy was analyzed.Results Compared with the control group,the values of VI,FI and VFI in the vascular microcirculation parameters of scar site of pregnant women in the observation group were higher,with statistical significance(P<0.05).Compared with the control group,the MRI parameters of pregnant women in the observation group showed higher scar thickness and lower residual muscle thickness,with statistical significance(P<0.05),but there was no statistical difference between the two groups in the thickness of pregnant women’s gestational sac adjacent to normal muscle layer(P>0.05).The ROC curve shows that the AUC of the parameters of vascular scar(VI,FI,VFI)and MRI parameters(scar thickness,residual muscle thickness)in predicting CSP were both more than 0.70,and the predictive value is ideal,especially the joint prediction AUC is the largest and the predictive value is the highest.Conclusion For pregnant women who are pregnant again after cesarean section,three-dimensional color p

关 键 词：子宫瘢痕妊娠 血管微循环参数 磁共振 预测价值 剖宫产 

分 类 号：R714.22[医药卫生—妇产科学] R445.1[医药卫生—临床医学]